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Meta-Analysis
. 2021 Dec 1;53(12):2661-2674.
doi: 10.1249/MSS.0000000000002735.

Home-based Physical Activity to Alleviate Fatigue in Cancer Survivors: A Systematic Review and Meta-analysis

Famke Huizinga  1 , Nico-Derk Lodewijk Westerink  1 , Annette J Berendsen  1 , Annemiek M E Walenkamp  2 , Mathieu H G DE Greef  3 , Juliët K Oude Nijeweeme  1 , Geertruida H DE Bock  4 , Marjolein Y Berger  1 , Daan Brandenbarg  1
Affiliations
Meta-Analysis

Home-based Physical Activity to Alleviate Fatigue in Cancer Survivors: A Systematic Review and Meta-analysis

Famke Huizinga et al. Med Sci Sports Exerc. .

Abstract

Purpose: Physical activity (PA) affects fatigue and mental health in cancer survivors favorably, but participation in PA interventions tends to be low. More participants may be reached by home-based PA owing to greater accessibility and self-monitoring. This systematic review therefore evaluated the effects of home-based PA of low to moderate intensity on symptoms of fatigue, depression, and anxiety among cancer survivors.

Methods: PubMed, CINAHL, PsycINFO, and Web of Science were systematically searched for randomized controlled trials. We included investigations of home-based PA interventions in adults treated curatively for cancer and evaluating fatigue, depression, or anxiety as outcomes. We performed a random-effect meta-analysis for the effects of PA interventions on fatigue in the short and long terms. Subgroup analyses were performed for the frequency of counseling. Standardized mean differences (SMD) and 95% confidence intervals are reported.

Results: Eleven articles comprising 1066 participants were included: 77% had a history of breast cancer; 14%, ovarian cancer; 4%, colorectal cancer; 4%, prostate cancer; and 1%, "other" cancer (not specified). Concerning the outcomes, nine articles reported on fatigue and two reported on depression or anxiety. Meta-analyses showed a significant effect of home-based PA on fatigue immediately after the intervention (SMD = 0.22 [0.06-0.37]), at 3 months' follow-up (SMD = 0.27 [0.04-0.51]), and at 6-9 months' follow-up (SMD = 0.31 [0.08-0.55]). PA interventions that used frequent counseling were associated with larger improvements in fatigue than those using no or infrequent counseling.

Conclusions: Home-based PA interventions can reduce fatigue among adult cancer survivors for up to 9 months, and frequent counseling may improve the benefits of these interventions.

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Figures

FIGURE 1
FIGURE 1
Flowchart of study selection. PA, physical activity; RCT, randomized controlled trial.
FIGURE 2
FIGURE 2
Forest plot of the meta-analysis on fatigue after the intervention (A), at follow-up of 3 months (B), and at follow-up of 6 to 9 months (C). CI, confidence interval.
FIGURE 3
FIGURE 3
Forest plot of the meta-analysis on fatigue for no or infrequent counseling (A) and frequent counseling (B). CI, confidence interval.
FIGURE 4
FIGURE 4
Risk of bias assessment of the included studies.
See this image and copyright information in PMC

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